Medtronic has taken a “long-term view” of India, but can absorb only some (pricing) pressures US-based biomedical technology company Medtronic, which manufactures cardiac stents and pacemakers, is keen to forge “value-based” public-private partnerships (PPPs) with government and healthcare stakeholders to improve patient outcomes. Complimenting the government’s ambitious scheme Ayushman Bharat, Omar Ishrak, the India-born chairman and CEO of the nearly $30-billion company, tells TOI in an exclusive interview that Medtronic has taken a “long-term view” of India, but “can absorb only some (pricing) pressures”. Excerpts:

How have you seen the healthcare landscape changing in India over your last few visits?

People are improving models of healthcare around the world. I think India is in the very early stage of this journey, but at least it has started. With the launch of the Indian government’s initiative, the first few steps have been taken. It’s now about the vision, about providing healthcare and then building a system, over time. I met with some of the government officials, and was struck by a number of things — the structure, thinking about the infrastructure, private & public infrastructure, and the payment mechanism. The methodology for payment at this point is very crude, but it’s a start.

What kind of partnerships/models came up for discussions with government and private hospitals here?

We will work with the government to understand and create better outcomes that are meaningful to patients, based on which we will figure out how to create a fair payment methodology. We have business models where technology and outcomes are directly related. We work with data and evidence, and will structure a methodology where better outcomes are realised, and there is improved financial benefit. It’s one of the things that we can work on here — either with private hospitals and go directly to the patients, and certainly systematically with the government.

There could be a system where public infrastructure is operated with private partners, or a mix between a collection of private partners, and we could be one, a provider could be the other, and a government body that runs the infrastructure could be another, in a payment mechanism. An example of something we will introduce next year in India, that has been the most successful of our value-based model, is called TYRX — an anti-bacterial sleeve, which is an implantable cardiac product. This is a business model where we have scaled.

In UP, there is some thought about picking up specific cardiology procedures and building a model that has to be linked with the government base scheme.

How has Medtronic fared after the price caps imposed by the government on cardiac stents?

First, that didn’t help us, but also it’s relatively arbitrary and not sustainable. We are trying to manage through it. But if it’s a forcing function for a country to develop a true value-based model, then we will do it — that price is worth paying. We don’t know the exact numbers (market shares) but we are still here. But we have made some changes in the way we stack our products. There are certain segments where we are unable to sell because there the product choices are made based on innovation and quality of outcome — we have the product of choice, but in certain segments where only the price becomes the issue, we walked away. Investment has to have a return at some time.

What has been the company’s growth in India?

It’s reasonable, and double-digit now, but should be more. Our cardiology franchise is still the largest right now, while minimally-invasive therapies group is growing well. The business is very small, especially compared to the population. I think it’s not even 1% of the global turnover of the company.

With immense pride “India Live” celebrated its 10th national conference in Mumbai from 28th February to 3rd March 2019. The conference turned out to be a gold mine of information, with emphasis on academics, education and exchange of knowledge with leaders in interventional cardiology from both India and abroad.